Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre. Despite the rosy picture painted by home birth advocates, a seemingly normal labor and delivery can quickly become life-threatening for both the mother and baby.
Attempting a vaginal birth after cesarean (VBAC) at home is especially dangerous because if the uterus ruptures during labor, both the mother and baby face an emergency situation with potentially catastrophic consequences, including death.
ACOG encourages all pregnant women to get prenatal care and to make a birth plan.Really??? Then don't ignore our birth plans when we make them. And put pressure on the hospital staff to respect them, as well. How come the L&D nurses think that birth plan = cesarean section? What's up with that?
The main goal should be a healthy and safe outcome for both mother and baby. Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby.
When looking through this lens, it becomes clear that lawyers and insurance companies have more to gain from legislation mandating insurance policies for midwives than do birthing women and their families.
This frequent contributor argues convincingly that making malpractice insurance mandatory for midwives will lead to more profitable lawsuits and decrease the number of homebirth midwives to deliver babies, rather than improving birth outcomes or public health.
People in prison are the only group in the United States with a constitutional right to medical care. ... In practice, however, securing needed medical care can be daunting, as numerous lawsuits and investigations attest. Women encounter multiple barriers to care - from co-payments they can ill afford to having to convince a guard that they need to see a doctor. Gynecological and obstetric care is often woefully inadequate. In a nationally representative government study, 20 percent of pregnant women in prison reported getting no prenatal care, and 50 percent of pregnant women in jails went without care.
U.S. immigration officials said they have enacted a new policy to show greater consideration for breast-feeding mothers, days after authorities arrested a Honduran woman in Ohio on an immigration violation and separated her from her crying baby.Sayda Umanzor, 27, admitted to being in the United States illegally when sheriff's deputies and federal agents knocked on the door of a house in Conneaut, Ohio, on Oct. 26.
Umanzor was breast-feeding her 9-month-old daughter, Brittany, at the time, and the baby cried as her parents were led away.
"It was like a piece of me was torn away," Umanzor said Thursday, speaking through an interpreter.
The baby cried incessantly over the next several days as she went without breast milk and Umanzor suffered soreness from engorged breasts.
Greg Palmore, a spokesman for Immigration and Customs Enforcement, or ICE, said the agency approved Wednesday a new policy to address the needs of breast-feeding mothers.
"It basically ensures that you take humanitarian issues involving nursing moms into consideration," he said Friday. "It also ensures we make contact with state social service agencies to address caregiver issues."
In Umanzor's case, the first jail where she was held did not know it had a nursing mother until Monday, when Lucia Stone, a Spanish-speaking representative of the La Leche League of Ohio, alerted them, said jail commander William Schultz.
Schultz said jail officials then accepted a breast pump and tried to work with local Spanish-speaking mothers to get milk to the baby, but the two sides failed to connect, and the milk had to be thrown out.
Umanzor was transferred to a county jail in Tiffin, Ohio, before immigration lawyer David Leopold secured her release Tuesday night. Leopold argued it was inhumane to hold a nursing mother and unnecessary to jail someone who the ICE knew how to find.
Umanzor was permitted to rejoin her children and was fitted with an ankle bracelet that tracks her whereabouts. She is expected to be deported soon.
Umanzor's husband, Marcus Antonio Bejarano, also an illegal immigrant from Honduras, was taken into custody. A 5-year-old son, David, also has been ordered deported. The couple's 9-month-old baby and a 3-year-old daughter, Alexandra, are U.S. citizens.
With the spectacular growth in the number of homeschooled students, it is becoming more difficult to reach these youth to ensure that they are immunized at all. These children are frequently unvaccinated, leaving them open to infection with diseases that are all but stamped out in the United States with immunization requirements. States should encourage parents to get their homeschooled students vaccinated through enacting the same laws as those used for public school students. This could be done by enforcing current laws through neglect petitions or by requiring that children be immunized before participating in school sponsored programs. As most states require some filing to allow parents to homeschool their children, it would be easy to enact laws requiring that homeschooled children be immunized or exempted before completing registration.
The incident happened in August 2006, but was reported in Japan on Thursday in the wake of the case of a 38-year-old woman who suffered a miscarriage last month after ten hospitals refused to admit her and her ambulance collided with another car.
The cases have raised concerns about shortcomings in emergency care for pregnant women, an growing worry as Japan grapples with declining birthrates - among the lowest in the world - and a burgeoning elderly population.
...
Last year, a pregnant woman in western Japan died after being refused admission by about 20 hospitals that said they were full.
I just want to remind the media and all of the Presidential candidates not to dismiss us. We "Mommy bloggers" are a force that can't be denied. We are well educated and vocal. We are doctors and lawyers and journalists and political followers. We care deeply about the future of our children and this country. We have checkbooks and blogs and we aren't afraid to use them.
Take heed, candidates. We may be mothers and we may be women, but we will not be ignored.
Well, I'm back from the Applebee's protest. I'm exhausted! We had 30 adults (moms, dads, and grandparents) and over 50 babies and children. But no press :( despite all my efforts at sending out press releases this week. One station (NBC5) did carry a blurb on the six o'clock news, just using the information we provided, but did not have the personnel to send a crew out to the protest itself. Numbers are still coming in, but looks like nationwide we had nearly 2000 people at 101 events in 43 states.
No person shall interfere with a mother breastfeeding her child in any location, public or private, where the mother is otherwise authorized to be.
Shortly following the incident, Ms. Ryan retained the services of a lawyer who contacted Thomas and King, the company that owns and operates the Lexington Applebee's location. Nearly 2 months later, the company responded with a letter stating "we are considering keeping blankets in the restaurants for use by breastfeeding mothers that may not have them readily available,"...
"A lot of the issues that are the general issues for pregnant women are magnified in prison. For instance, which provider will you choose for pregnancy and childbirth? In prison, you don't get to choose your provider - not being able to choose who attends your birth is a big deal. Up until recently, in the prison we work in, there was only a male doctor available for labor and delivery. But for many women in prison - a huge number of whom have experienced sexual and domestic violence - having a male provider between your legs is not exactly ideal. Another issue is lack of informed consent - the lack of information and resources around having a healthy pregnancy for these women is huge. They just aren't given any information on pregnancy, their health, their bodies. The lack of access to proper nutrition during pregnancy is a big problem - the pregnant women in the prison we work with get "extra canteen" which means they get like an extra pack of Fritos. Also, the lack of access to health care in prison means that, in general, a health issue is not dealt with until it turns into a huge problem. It's a high-risk population anyway because, for the most part, these women lacked proper health care before coming to prison and being pregnant in prison doesn't change that. Also, there is a much higher rate of cesarean sections for women in prison as compared to women on the outside - mostly for the convenience of medical and prison staff."
To [Mairi Breen] Rothman, [a nurse-midwife and spokeswoman for the American College of Nurse-Midwives, which does not support unassisted childbirth], Shanley's beliefs underscore a more fundamental problem with maternity care. "To me the really interesting question is, Why would someone go outside the system?" Rothman said. "What is so broken that they don't want to use it?"
[Heather] Jones, the Navy wife, has an answer. Her first delivery in a hospital four years ago was marred by "interventions and interferences based on someone's outside judgment" of how well her labor was progressing, she said. She said she felt pressured to have epidural anesthesia, was not allowed to move around as she wished and was denied access to her baby until he was two hours old because he was being observed by the hospital staff.
Jones said she decided to give birth to her third child unattended after her second was born five minutes after the midwife arrived at her home."
She was like, 'See, you didn't need me,' and I thought, 'You know, maybe I don't,' " she said, as baby Gideon, now 5 months old, cooed in the background.
Watch-maker and clothier Fossil Inc. agreed to pay $3,600 to a woman who was barred from breast-feeding her infant while visiting a company showroom, the New York Civil Liberties Union said on Tuesday.Lass King, 37, a buyer for a Maine clothing store and a mother of two, said she received a letter of apology and the payment from Fossil after threatening the company with a lawsuit.
In its letter to King, Fossil also said it had issued a policy affirming that breast-feeding was permitted in all Fossil stores and showrooms, said Galen Sherwin, director of the NYCLU's Reproductive Rights Project.
Representatives of Fossil could not immediately confirm details of the settlement.
New York law states that women are permitted to breast-feed "in any location, public or private, where the mother is otherwise authorized to be."
A woman has won a court fight to keep the placenta after her daughter's birth. She had planned to grind it up and ingest it as a way to fight postpartum depression, but now plans to bury it.
Clark County District Court Judge Susan Johnson granted a preliminary injunction Tuesday, ordering Sunrise Hospital and Medical Center in southern Nevada to return the placenta to Anne Swanson. Hospital officials said they will comply.
Amy Stevens, system vice president for Sunrise Health, which operates Sunrise Hospital, described the ruling as specific to Swanson. She said the hospital must comply with strict regulations in handling human biohazardous waste.There is no Nevada law prohibiting hospitals from returning placentas to mothers. But several Las Vegas area hospitals told the Las Vegas Review-Journal the organ is usually destroyed unless a physician designates it for medical tests or a patient seeks it for specific religious or cultural reasons.
TSA is also modifying the rules associated with carrying breast milk through security checkpoints. Mothers flying with, and now without, their child will be permitted to bring breast milk in quantities greater than three ounces as long as it is declared for inspection at the security checkpoint.
Breast milk is in the same category as liquid medications. Now, a mother flying without her child will be able to bring breast milk through the checkpoint, provided it is declared prior to screening.
Under the old TSA rule, pumped breastmilk had to be packaged in 3 oz containers all of which had to fit into one 12 oz ziplock bag. Birth Without Boundaries has assisted many women whose pumped milk was confiscated and dumped by TSA security officers, either because it was not packaged according to regulation or because the TSA officer did not know what the regulation was. All of our complaints to the TSA have gone unanswered, until now.
A federal judge has dismissed a lawsuit filed earlier this year by a former Mendon midwife in a bid to have her license to practice in Vermont reinstated.
Roberta Devers-Scott claimed in the lawsuit that the state violated her due process rights, leading to the revocation of her midwife license. Secretary of State Deborah Markowitz, whose office oversees professional licensing of midwives in Vermont, was among the defendants named in the lawsuit.
Judge J. Garvan Murtha issued a six-page ruling in U.S. District Court in Brattleboro granting a motion filed on the defendants' behalf dismissing the lawsuit, ruling, in part, Markowitz had immunity from the lawsuit.
Michael Sussman, Devers-Scott's attorney, said Friday he planned to appeal the judge's ruling to the 2nd Circuit Court of Appeals in New York City.
The [Huntington Beach] City Council unanimously voted to ban public nudity during its Monday meeting after a brief debate that resulted in striking portions of the proposed ordinance.The council decided to limit the law to being nude where it is visible from a public area. They deleted regulations on a women breastfeeding an infant older than age 2, and restrictions on wearing a costume or device that simulated nudity.
The article goes on to say:
This type of ordinance is not new to cities in Orange County. More than half of the cities in the county have approved similar bans on public nudity, said [Police Chief Kenneth] Small.
It is legal for a Florida LM to do a primary VBAC, but it does carry a risk score of 3, which requires a consult from a VBAC friendly doctor. Some midwives who can not get consults have mistakenly told people "its illegal to do VBACs at home" when they mean "it is illegal for me to do VBACs at home because I can not get the proper consult to comply with the law".
So you can legally have a VBAC with a homebirth Licensed Midwife, as long as she obtains a consult from a physician with OB privileges. There is a state risk assessment score for LMs that assigns points for various risk factors, and when your points reach 3 for any reason, you must have a consult with a physician that does obstetrics. A prior c-section scores 3 points for "prior uterine surgery". Prior uterine surgery with a subsequent successful vaginal birth (a secondary VBAC) is only 2 points. So if the mother has no other point scoring risk factors, she will only have a 2, and thus can have a VBAC with out consult. If she smokes, is over/underweight, or has other factors, she will need a consult based on her overall points. The risk assessment is in the rules, which can be viewed online at http://www.doh.state.fl.us/mqa/midwifery/mw_statutes.html under Rules: Chapter 64B24, its a large document and you must scroll down to Chapter 64B24-7, Midwifery until you see the Midwifery Practice Act, which includes the risk assessment. You can also get a risk screening tool from any practicing midwife.
If the midwife also has a birth center, that complicates things further. The birth centers are governed by a separate law, and it says the birth centers can only do VBACS in the birth center if they are participating in the National VBAC study, which has been closed for 7 years. So there has been no way to comply with birth center law, so there is no way to legally do a VBAC in the birth center. But midwives who own birth center will often do VBACs at home, even though they can not do them in the center.
I know an attorney that was drawing up a consent to allow midwives and moms to choose to go outside of the law or rules, as part of the alternative medicine law, but I do not know if anyone actually does that yet.
The American Association of Birthing Centers, the birth center association, is going to open the National VBAC study up again soon, thanks to Charlynn Daughtery a Tampa midwife that own Labor of Love Birth Centers. She has really been a strong VBAC advocate in political circles, working hard to keep VBAC options open at home and birth centers. Once that study open, hopefully in Fall, Florida women will be able to have VBACs in birth centers if the consults are obtained. You can contact them, AABC, to urge them to get the VBAC study opened again.
So, as it stands- in Florida you CAN have a VBAC at home, but not in a birth center, as long as the proper consults are obtained. Many women travel 3 hours or so to get the consult, at around 28 weeks, but you can usually get the consult anytime including preconception. It is generally just a review of your surgical record, and a conversation on risks and benefits.
The issue of breastfeeding in Parliament made headlines in 2003 when Victorian Labor MP Kirstie Marshall was thrown out of State Parliament for breastfeeding.
Committee members said the debate had resurfaced in light of an increasing number of new mums in the House of Representatives in the past decade.
The committee found only 10 female MPs had given birth while in office - out of a total of about 130 female MPs.
"Women have faced the difficult choice between prioritising their duties as a member with those of being a mother," members said.
Pennsylvania's governor signed that state's breastfeeding legislation. Although breastfeeding advocates would have preferred a stronger bill, it's better than nothing.
A senator secretly attached the provision to a bill intended to make health insurance more accessible to some Missourians. Gov. Matt Blunt signed the bill into law.
Several physician groups sued last Thursday, claiming the midwife language violates the Missouri Constitution by going beyond the bill’s health insurance title and by changing the bill’s original purpose.
The recently passed legislation says that regardless of the current felony statute, anyone with a “tocological certification” — meaning in obstetrics — from a privately accredited group can provide services related to pregnancy.
The title of the bill that passed described it as “relating to health insurance.”
"The authorities in California are investigating accusations that poor health care at a center where mothers serve prison terms with their young children led to the stillbirth of a 7-month-old fetus and endangered the lives of several children.
Staff logs, statements by prisoners and interviews with investigators, staff members and prisoners’ families depict a facility where inmates and their children were denied hospital visits and medications, and where no one kept adequate records of accidents involving injuries that included a skull fracture and a broken collarbone."
Transparency is suddenly a big deal. This government report follows on the heels of efforts in New York City, and communities across the country, to improve the level of transparency related to childbirth. Giving birth in the dark is an apt metaphor for the current state that women find themselves in when attempting to access information about maternity care. The recent NYC public advocates’ report identified that city hospitals although legally mandated to do so, are still failing to provide maternity information. Public Advocate Betsy Gotbaum is working tirelessly to insure that hospitals do what they are legally mandated to do…including reporting induction and cesarean rates.
HOW A BILL BECOMES LAW
The following steps trace the process by which a paternal proclamation becomes law in the Cameron household.
Step One:
The father of the house issues an executive order that all Saturday activities will be suspended until the garage is cleaned up.
Step Two:
The children form a committee and produce a report finding the order totally unconstitutional, because it violates the "Cruel and Unusual" clause.
Step Three:
The committee report is voided by paternal declaration.
Step Four:
The ruling is appealed under the "This is stupid nobody else has to do this kind of stuff" doctrine of the "Equal Protection" clause. Specific examples are cited of other children who are not cleaning their garages.
Step Five:
The "nobody else has to" doctrine is rejected as having no bearing on the case.
Step Six:
Each child petitions separately for the relief under the "why do I have to do it none of it is my junk" theory.
Step Seven:
The father rules that the individuals of the household are a family, that the junk in the garage belongs to the family, and that the family has the responsibility of cleaning it up.
Step Eight:
The children attempt to stay the executive order by evading subpoena.
Step Nine:
The father retrieves the children from their bedrooms and declares notice properly served.
Step 10:
The children plead pre-existing obligations that preempt the paternal proclamation. The oldest is due at the shopping centre, the middle child has to go to a soccer game, and the youngest is yeah me too.
Step 11:
Clarification is sought from the youngest on which of the two lame excuses is yeah me too: soccer game or the mall?
Step12:
The youngest says the soccer game.
Step 13:
The father rules the soccer game cannot preempt the garage cleanup.
Step 14:
The youngest says I meant the mall.
Step 15:
The father rules the mall cannot preempt the garage cleanup.
Step 16:
The children pass a resolution that the father is the meanest man in the world.
Step 17:
The father agrees to accept the "meanest man" amendment and calls for an end to the debate.
Step 18:
The children submit an emergency appeal on the grounds that there might be mice living in the garage.
Step 19:
The father issues an executive decree that he has authority over all rodents and that there are no mice in the garage.
Step 20:
The children move for dismissal, claiming they are exempt because they have homework to do.
Step 21:
The father consults the official Cameron family calendar and determines there is another day left in the weekend in which homework can be done.
Step 22:
The children file a grievance with the Supreme Court of the house: their mother. A restraining order is sought prohibiting enforcement of the father's executive order on the grounds that he never listens, he is ruining our lives, he's mean, and if he really wants the garage cleaned up, why doesn't he do it himself?
Step 23:
A constitutional crisis is averted when the wife hands down a decision supporting the father's right to order the children to clean up the garage.
Step 24:
The children declare themselves no longer members of the family. As stateless persons, they are not subject to parental authority.
Step 25:
The father agrees to expedite the emigration of each child on the date they are of age. Until the parents are released by the laws of the locality from their obligations, however, the family members are stuck with each other. Meanwhile, the father identifies further sanctions to be imposed upon delay of compliance with his order, including suspension of telephone privileges.
Step 26:
The teenagers file a brief equating telephone cut-off with capital punishment.
Step 27:
The father further suspends all use of the family automobile until the garage is cleaned up enough to park the car in it.
Step 28:
The children petition for relief from further sanctions by agreeing to clean up the garage.
Thus, with these simple 28 steps, a bill moves through the checks and balances and becomes law.
It may not be the best system, but it's the only one we've got.
The practice of lay midwifery has been illegal in Wyoming since 2003. However, Wyoming does allow for the practice of midwifery by Certified Nurse Midwives, CNMs. CNMs are registered nurses who have advanced training and skill in care of women and newborns at birth. CNMs are licensed by the Wyoming State Board of Nursing and practice in homes and hospitals.
Gladys Breeden of the Wyoming State Department of Vital Statistics claims to be aware of 8 lay midwives who practice in the State of Wyoming and one certified nurse midwife who practices legally with a Wyoming License. The Department of Vital Statistics is responsible for the filing of birth certificates in Wyoming.
Breastfeeding support groups have condemned the actions of an attendant who fined a mother for parking in a restricted area to feed her child and then took photographs for proof.This incident occurred in Scotland, where anyone who interferes with breastfeeding can be fined up to £2,500 (nearly $5,000). Since Scotland is the first (known) jurisdiction to impose a fine for interfering with breastfeeding, the language of the law (.pdf) could be a model for other jurisdictions to follow:
The warden employed by a national car park management company confronted Jerricah Watson, 19, after she pulled into a permit holders-only bay in the Candle Lane area of Dundee to breastfeed her 14-week-old son Jaksyn.
Ms Watson pulled into the quiet street to get away from the city-centre traffic and said the warden initially said it was okay to feed her child. She said he then took photos and put a ticket on her car.
When she approached the attendant, from Birmingham-based Central Ticketing, which is responsible for policing the parking in the area, he said it was too late to withdraw the ticket. The penalty was for £85 or £60 if paid within two weeks.
"As I'm breastfeeding and therefore my son is fed on demand, I need to stop right away," she said.
"I feel with the government both locally and nationally trying to encourage mums to breastfeed that it was unfair of the man not to take that into account or even bother to ask me to move or give me a few minutes to feed my child."
The incident has alarmed breastfeeding support groups who believe more should be done by government to allow babies to be fed naturally.
Gillian McWhirter, a Scottish breastfeeding support group adviser, said: "This is a very unfortunate situation. There is enough of a problem getting mothers to breastfeed because they are embarrassed to do it in public. But to not just give this woman a ticket but take pictures of her while she was in the car, is quite shocking.
"These kind of situations encourage ignorance over the importance of breastfeeding, which scientific evidence shows decreases the rate of infant illness.
"It is a basic right for a child to receive nutrition and every mother knows that when baby cries, baby has to be fed."
Thyll Buchanan, a registered Scottish breastfeeding network supporter, added: "Young mothers need all the help and support they can to continue to breastfeed. It is safer to pull over and feed a crying baby than to try and continue driving under stressful conditions."
Central Ticketing said it would cancel the ticket if an investigation into the mother's complaint found her story to be true. Part of the inquiry would involve examining pictures taken by the parking attendant.
"We will see if this woman's story stacks up, because the warden would have taken photographs and she would have been in the vehicle," said the spokesman.
"We issue thousands of parking charges a week. Fifty per cent of people send in an appeal. You have to bear in mind of every 10 letters we receive seven or eight of these members of the public are telling lies. We are not saying this woman is. This will be investigated."
Figures released last month show that fewer Scottish mothers are opting to breastfeed despite numerous government campaigns promoting the health benefits.
Last year, only 44.2% of mothers were breastfeeding at the time of a health worker's first visit when the baby is about 10 days old while 36.6% were doing so after six to eight weeks. That compares with 45.1% and 37.2% respectively in 2005.
1 Offence of preventing or stopping a child 5 from being fed milk(1)Subject to subsection (2), it is an offence deliberately to prevent or stop a person in charge of a child from feeding milk to that child in a public place or on licensed premises.
(2) Subsection (1) does not apply if the child, at the material time, is not lawfully permitted to be in the public place or on the licensed premises otherwise than for the purpose of being fed milk.
(3) A person guilty of an offence under subsection (1) is liable on summary conviction to a fine not exceeding level 4 on the standard scale.
(4) In this section—
"child" means a person who has not yet attained the age of two years;
"feeding" includes—(a) breastfeeding; and"licensed premises" means premises licensed under—
(b) feeding from a bottle or other container;(a) section 12 of the Theatres Act 1968 (c.54);"milk" means breastmilk, cow’s milk or infant formula;
(b) Part II of the Licensing (Scotland) Act 1976 (c.66);
(c) Part II of the Civic Government (Scotland) Act 1982 (c.45); or
(d) section 1 of the Cinemas Act 1985 (c.13);
"public place" means any place to which, at the material time, the public or any section of the public has access, on payment or otherwise, as of right or by virtue of express or implied permission.
I'm not implying that the parking attendant violated the Scottish law, it just seemed like a good opportunity to blog about Scotland. I like the fact that the statue defines "public place". Although the definition of "public place" is probably well-defined in the case law of US states, the definition was not incorporated into most breastfeeding statues, leading to some confusion among the general public.
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